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Open Access Highly Accessed Editorial

Ready for a world without antibiotics? The Pensières Antibiotic Resistance Call to Action

Jean Carlet1*, Vincent Jarlier2, Stephan Harbarth3, Andreas Voss4, Herman Goossens5, Didier Pittet3 and the Participants of the 3rd World Healthcare-Associated Infections Forum6

Author Affiliations

1 Consultant, WHO African Partnerships for Patient Safety, 9 rue de la Terrasse, 94000 Créteil, France

2 UPMC University Paris 6 EA, 154 Laboratory of Bacteriology-Hygiene and Microbiology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, 47-83 Boulevard de l'Hôpital, 75013 Paris, France

3 Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland

4 Canisius-Wilhelmina Ziekenhuis and Radboud University Medical Centre, NTPDRD189, Postbus 9015, 6500 GS, Nijmegen, The Netherlands

5 Laboratory of Medical Microbiology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium

6 3rd World Forum on Healthcare-Associated Infections, Annecy, France, 27-29 June 2011

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Antimicrobial Resistance and Infection Control 2012, 1:11  doi:10.1186/2047-2994-1-11

Published: 14 February 2012

Abstract

Resistance to antibiotics has increased dramatically over the past few years and has now reached a level that places future patients in real danger. Microorganisms such as Escherichia coli and Klebsiella pneumoniae, which are commensals and pathogens for humans and animals, have become increasingly resistant to third-generation cephalosporins. Moreover, in certain countries, they are also resistant to carbapenems and therefore susceptible only to tigecycline and colistin. Resistance is primarily attributed to the production of beta-lactamase genes located on mobile genetic elements, which facilitate their transfer between different species. In some rare cases, Gram-negative rods are resistant to virtually all known antibiotics. The causes are numerous, but the role of the overuse of antibiotics in both humans and animals is essential, as well as the transmission of these bacteria in both the hospital and the community, notably via the food chain, contaminated hands, and between animals and humans. In addition, there are very few new antibiotics in the pipeline, particularly for Gram-negative bacilli. The situation is slightly better for Gram-positive cocci as some potent and novel antibiotics have been made available in recent years. A strong and coordinated international programme is urgently needed. To meet this challenge, 70 internationally recognized experts met for a two-day meeting in June 2011 in Annecy (France) and endorsed a global call to action ("The Pensières Antibiotic Resistance Call to Action"). Bundles of measures that must be implemented simultaneously and worldwide are presented in this document. In particular, antibiotics, which represent a treasure for humanity, must be protected and considered as a special class of drugs.

Keywords:
antibiotic resistance; antibiotic stewardship; infection control; hand hygiene; surveillance networks; care bundles; environment; regulations; human medicine; animal medicine